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Fellowship Directors’ Grassroots Session Brief Announcements- PAS preconference for fellowship directors May 3 rd - Washington, DC 4 workshops & 3 sessions related to ACGME, ABP, and EPAs PRESENT: 31 fellowship directors, 2 coordinators, 1 DIO, and 1 superfellowship director. Topic ideas discussed focused mainly on areas of common ground between subspecialties and included the following 5 topics: Topic 1. Revisions to the assessment process involving the subspecialties were discussed. There was a brief report about the ABP foundation funding a meeting at the board in March 2013 to begin to discuss/develop EPAs for fellowship programs. a. EPAs: i. Common for all subspecialists ii. Subspecialty specific iii. Milestones are a grade used for assessment, EPAs are a tool. Further changes to the NAS for the subs will depend on piloting results from pediatric categorical programs. ACGME Subspecialty requirements have not been updated as of yet but the expectation is that milestones will be used for fellow evaluations- no tool will be mandated. This was generally regarded as a wait and see issue for implementation. Action Items for Topic 1: Continue to include speakers in FPD sessions at PAS forum for fellowship directors and APPD Fall sessions in order to track milestones/EPAs development. Consideration for APPD involvement from FPDs to review and comment on proposed drafts of fellowship milestones-might need to be written for any new EPAs. Topic 2. We discussed the needs of fellowship programs related to scholarship/curricula and faculty development needs for FPDs. The challenge -How do FPDs solve scholarship and/or curriculum issues with limited resources? Questions discussed: Specifically what do FPDs need to know about each of these issues?”

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Page 1: Fellowship Directors’ Grassroots Session - APPD€¦ · Fellowship Directors’ Grassroots Session Brief ... 2013 to begin to discuss/develop EPAs for ... fellowship training? Is

Fellowship Directors’ Grassroots Session Brief Announcements- PAS preconference for fellowship directors

May 3rd- Washington, DC 4 workshops & 3 sessions related to ACGME, ABP, and EPAs PRESENT: 31 fellowship directors, 2 coordinators, 1 DIO, and 1 superfellowship director. Topic ideas discussed focused mainly on areas of common ground between subspecialties and included the following 5 topics: Topic 1. Revisions to the assessment process involving the subspecialties were discussed. There was a brief report about the ABP foundation funding a meeting at the board in March 2013 to begin to discuss/develop EPAs for fellowship programs.

a. EPAs: i. Common for all subspecialists ii. Subspecialty specific iii. Milestones are a grade used for assessment, EPAs are a tool.

Further changes to the NAS for the subs will depend on piloting results from pediatric categorical programs. ACGME Subspecialty requirements have not been updated as of yet but the expectation is that milestones will be used for fellow evaluations- no tool will be mandated. This was generally regarded as a wait and see issue for implementation.

Action Items for Topic 1:

Continue to include speakers in FPD sessions at PAS forum for fellowship directors and APPD Fall sessions in order to track milestones/EPAs development.

Consideration for APPD involvement from FPDs to review and comment on proposed drafts of fellowship milestones-might need to be written for any new EPAs.

Topic 2. We discussed the needs of fellowship programs related to scholarship/curricula and faculty development needs for FPDs. The challenge -How do FPDs solve scholarship and/or curriculum issues with limited resources? Questions discussed:

“Specifically what do FPDs need to know about each of these issues?”

Page 2: Fellowship Directors’ Grassroots Session - APPD€¦ · Fellowship Directors’ Grassroots Session Brief ... 2013 to begin to discuss/develop EPAs for ... fellowship training? Is

“Where can they get the training they need?”

“What is the “standard” for fellowships of various sizes?”

“What are other programs doing compared with mine?”

“Should there be a method to determine the faculty time, coordinator time, financial resources, and information to assist program directors to justify the time it takes to be a fellowship program director?”

Are other members of the CCCs given protected time to be involved in fellowship evaluation process?”

The group felt that this was important. There was definite consensus that the development of “standards” will help FPDs be much more successful in negotiations. Many chairs ask FPDs what other programs are doing but it is unclear because there is an apparent lack of any data about what this job description. Action items for Topic 2- The group recommended that a survey be considered to explore fellowship program resources to include:

Program director specific questions- FTE/fellow, by subspecialty type and program size

Program specific questions- Coordinators/support/curriculum/core curriculum

Funding of programs/fellowship

Faculty development, allocation of time, collection of national data.

Time-- Centralizing? Division vs. GME funding PD time.

Resource needs- clarification of roles/expectations

Core Curriculum present and content. Ultimately, there should be a statement about the fellowship PD position. Maybe with CoPS and APPD? Topic 3- Do you have suggestions of ways that APPD can help fellowship program directors? Major discussion points:

Discussion regarding resources of fellowships vs. categorical programs at meetings.

Briefly discussed ways in which APPD can become more effective “educational home” for FPDs to meet and develop content?

Centralization of administrative resources/policies/ideas.

Logistics of collaboration/support for fellowships given at other meetings. virtual world/listserve/webinars regional meetings

Gathering data to better describe resources, problem solving methods and mentorship for new programs. Best practices and postings of ideas or solutions or models of behaviors.

Do FPDs even know there are members of APPD?

Should there be a regional system in place for content delivery?

Page 3: Fellowship Directors’ Grassroots Session - APPD€¦ · Fellowship Directors’ Grassroots Session Brief ... 2013 to begin to discuss/develop EPAs for ... fellowship training? Is

Action items for Topic 3- A. Strongly consider development of bidirectional communication listserve for fellowship

program directors- could be google/ yahoo based vs consider asking APPD for help. B. Request better website for information and curriculum sharing...specific area on

website C. Raise awareness of FPDs who are APPD members that they are members and

highlight resources. Topic 4 -We outlined some areas of need across all subspecialty programs: Content to consider for potential development among programs.

A. Remediation, what does it mean? What should it include? Current fellows vs fellows with lapsed board eligibility.

B. Should we build content guidelines for retraining (for lapse in certification, develop contacts lists of experience for sharing?

Action Item 4

Develop a fellowship remediation plan outline to address program director needs.

Topic 5- A core fellowship “Best Practice” resource document was suggested for subspecialty program directors to use as a resource for common (or shared) core elements. Suggestions for what this might look like included:

how a program administers core conferences and what is included in the content

assessment models

The discussion focused on improving efficiency by not having to recreate areas of commonality

Best practice resource list discussion highlights- Items that could be included:

Core curricular elements—outline vs. guidelines vs. template

Distribution method or posting on a website such as CoPS or APPD?

How does a “Super Fellow” Director function?

Structure of programs: o Coordinator as a full, shared FTE, vs. % of a single person in division. o Tool/module for development of teaching faculty o Duty hours considerations

Are things being unnecessarily repeated when taught in residency? Examples cited: Evidence Based Medicine/biostatistics

Page 4: Fellowship Directors’ Grassroots Session - APPD€¦ · Fellowship Directors’ Grassroots Session Brief ... 2013 to begin to discuss/develop EPAs for ... fellowship training? Is

What if a resident is competent in these areas during residency…will that count for fellowship training? Is there a plan for the communication of milestone achievement from residency to fellowship.

Structure of semi-annual meetings with fellows- Is the standard to include coordinators, other faculty?

Specific recommendations regarding retraining of FPDs. Where is the best mechanism?

Action items for Topic 5-

Develop a best practice needs list for pediatric fellowship director.

Collect and organize information and examples from programs.